title: Supraorbital keyhole approach for anterior circulation aneurysms.
abstract: OBJECTIVE
  Supraorbital keyhole approach provides access to the major part of the anterior circulation aneurysms. Herein, our surgical experience of supraorbital keyhole approach and its some modification have been proposed.
  
  
  METHODS
  Out of a series of 76 patients harboring 80 aneurysms operated on via a supraorbital keyhole approach with a superciliar or front wrinkle skin incision, there are 70 patients with subarachnoidal bleeding, others are nonruptured aneurysms, Intraoperative rupture occurred in 8 cases, and 4 had multiple aneurysms.
  
  
  RESULTS
  There was a good cosmetic results with less approach-related complications .Of 80 aneurysms, 75 aneurysms were clipped successfully by the supraorbital route. Good Glasgow Outcome Scale scores of 4 or 5 were achieved in 95% of the patients at the time of discharge. 2 patients of Grade IV died in the postoperative period due vasospasm.
  
  
  CONCLUSIONS
  The supraorbital route is recommended for selected anterior circulation aneurysms based on the improved surgical instruments and microsurgical skills.
authors.affiliation: Huashan Hospital Affiliated to Fudan University, Department of Neurosurgery, Shanghai, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Tang
authors.forename: Jun
authors.initials: J
authors.lastname: Sun
authors.forename: Hongli
authors.initials: H
authors.lastname: Xue
authors.forename: Yong
authors.initials: Y
authors.lastname: Yu
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
mesh_terms: D017542:Aneurysm, Ruptured / Q000601:surgery; D002533:Cerebral Angiography; D003399:Craniotomy; D023261:Glasgow Outcome Scale; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008866:Microsurgery; D019635:Neurosurgical Procedures / Q000379:methods*; D009915:Orbit / Q000601:surgery*; D011183:Postoperative Complications / Q000628:therapy; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000209:etiology